Anaphylactic Shock Case After Sugammadex Application

Abstract

Sugammadex is a synthetic gamma-cyclodextrin-derived agent that selectively encapsules nondepolarizing neuromuscular blockers (NMBAs) such as rocuronium. This case report aims to present a life-threatening anaphylactic shock that is thought to be related to sugammadex application after reversal of the neuromuscular blockade. The patient was a 59-year-old male who had a history of uncomplicated inguinal hernia repair under general anesthesia 10 years ago and had no additional disease. Endovascular coil embolization of cerebral aneurysm was planned under general anesthesia by the interventional radiology clinic. No complications related to surgery or anesthesia were observed during the operation. At the end of the operation, intravenous (IV) 200 mg sugammadex was administered to the patient. Approximately 2 minutes after extubation, the patient developed an anaphylactic reaction, which was thought to be due to sugammadex injection. The symptoms of the patient regressed with the administration of ephedrine, adrenaline and methylprednisolone. We should be aware of the fact that life-threatening anaphylactic reactions may develop after administration of sugammadex.